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European Respiratory Journal 08/15/2019 03:05
Neutrophilic inflammation in asthma is associated with interleukin (IL)-17A, corticosteroid-insensitivity and bronchodilator-induced forced expiratory volume in 1 s (FEV 1 ) reversibility. IL-17A synergises with tumour necrosis factor (TNF)-α in the production of the neutrophil chemokine CXCL-8 by primary bronchial epithelial cells (PBECs). We hypothesised that local neutrophilic inflammation in asthma correlates with IL-17A and TNF-α-induced CXCL-8 production by PBECs from asthma patients. PBECs from most asthma patients displayed an exaggerated CXCL-8 production in response to TNF-α and IL-17A, but not to TNF-α alone, and which was also insensitive to corticosteroids. This hyperresponsiveness of PBECs strongly correlated with CXCL-8 level.
European Respiratory Journal 08/15/2019 03:05
Influenza virus (flu) caused the worst disease mediated devastation in recorded human history in 1918, when global death was estimated to be between 50 and 100 million people [1]. Flu continues to kill more people every year with no apparent decrease in its pathogenicity despite advancement in our understanding of the disease and with the availability of vaccines and antiviral agents. Last year, the death toll of influenza was estimated to be 80 000 in the USA alone, making it the most lethal infectious disease [2]. One apparent change that occurred in the influenza virus is the emergence of influenza B strain as a significant contributor to the annual disease over the years. The origin of influenza B is unclear but was first isolated aroun.
European Respiratory Journal 08/15/2019 03:05
Human leukocyte antigen (HLA)-G is a non-classical HLA that inhibits immune responses. Its expression is modified by single nucleotide polymorphisms (SNPs), which are associated with transplant outcomes. Our aim was to investigate the association of donor and recipient HLA-G SNPs with chronic lung allograft dysfunction (CLAD) and mortality after lung transplantation. In this single-centre study, we examined 11 HLA-G SNPs in 345 consecutive recipients and 297 donors of a first bilateral lung transplant. A multivariable Cox proportional hazards model assessed associations of SNPs with death and CLAD. Transbronchial biopsies (TBBx) and bronchoalveolar lavage (BAL) samples were examined using quantitative PCR, ELISA and immunofluorescence. Over.
European Respiratory Journal 08/15/2019 03:05
When undertaken carefully, and in experienced hands, specific inhalation challenge (SIC) testing is widely considered to be the reference standard in the diagnosis of occupational asthma. In 2013 the European Respiratory Society commissioned a pan-European task force to produce standards for the conduct and interpretation of SIC with the aim of sharing expertise among those centres who offer the service and with centres who wish to develop a new service. The findings and recommendations of the taskforce were published in the European Respiratory Journal [1].
European Respiratory Journal 08/15/2019 03:05
We read with great interest the article on inhaled corticosteroids (ICS) and their effect on asthma progression and mortality recently published in the European Respiratory Journal [1]. The article presents an excellent review on asthma natural history, lung function evolution and the role of exacerbations in the course of the disease, and on mortality as well as the effect of ICS on the disease. We absolutely agree with the writers that the introduction of ICS has indeed made a huge impact on asthma morbidity and mortality. Before their introduction, severe asthma exacerbations and deaths were frequently seen in Europe, North America, Australia and New Zealand [2–4]. These were reduced drastically after the introduction of ICS and health p.
European Respiratory Journal 08/15/2019 03:05
Despite causing regular seasonal epidemics with substantial morbidity, mortality and socioeconomic burden, there is still a lack of research into influenza B viruses (IBVs). In this study, we provide for the first time a systematic investigation on the tropism, replication kinetics and pathogenesis of IBVs in the human respiratory tract. Physiologically relevant ex vivo explant cultures of human bronchus and lung, human airway organoids, and in vitro cultures of differentiated primary human bronchial epithelial cells and type-I-like alveolar epithelial cells were used to study the cellular and tissue tropism, replication competence and induced innate immune response of 16 IBV strains isolated from 1940 to 2012 in comparison with human seaso.
European Respiratory Journal 08/15/2019 03:05
Background. Exposure to cigarette smoke has been shown to lead to vascular remodelling. Computed tomography (CT) imaging measures of vascular pruning have been associated with pulmonary vascular disease, an important morbidity associated with smoking. In this study we compare CT-based measures of distal vessel loss to histological vascular and parenchymal changes. Methods. A retrospective review of 80 patients who had undergone lung resection identified patients with imaging appropriate for three-dimensional (3D) vascular reconstruction (n=18) and a second group for two-dimensional (2D) analysis (n=19). Measurements of the volume of the small vessels (3D) and the cross-sectional area of the small vessels ( <5 mm 2 cross-section) were computed.
European Respiratory Journal 08/14/2019 19:05
Background. The association between allergic diseases (ADs) and autoimmune disorders (AIDs) is not well established. Objective. To determine incidence rates of AIDs in allergic rhinitis/conjunctivitis (ARC), atopic eczema (AE) and asthma, and investigate for co-occurring patterns. Methods. Design: Retrospective cohort study (1990–2018) employing "The Health Improvement Network" (UK primary care database). Exposure group: ARC, AE and asthma - all ages. Controls: For each exposed patient, up to 2 randomly selected age- and gender-matched controls with no documented AD. Adjusted incidence rate ratios (aIRRs) were calculated using Poisson regression.
European Respiratory Journal 08/14/2019 19:05
This international randomised controlled trial evaluated whether COPD patients with comorbidities, trained in using patient-tailored multi-disease exacerbation action plans, had fewer COPD exacerbation days than usual care (UC). COPD patients (GOLD II-IV) with ≥1 comorbidity (ischaemic heart disease, heart failure, diabetes, anxiety, depression) were randomised to a patient-tailored self-management intervention (n=102) or UC (n=99).
European Respiratory Journal 08/08/2019 07:29
Protective immunity against Mycobacterium tuberculosis is poorly understood. The role of interleukin (IL)-4, the archetypal T-helper type 2 (Th2) cytokine, in the immunopathogenesis of human tuberculosis remains unclear. Blood and/or bronchoalveolar lavage fluid (BAL) were obtained from participants with pulmonary tuberculosis (TB) (n=23) and presumed latent TB infection (LTBI) (n=22). Messenger RNA expression levels of interferon (IFN)-, IL-4 and its splice variant IL-42 were determined by real-time PCR. The effect of human recombinant (hr)IL-4 on mycobacterial survival/containment (CFU·mL –1 ) was evaluated in M. tuberculosis- infected macrophages co-cultured with mycobacterial antigen-primed effector T-cells. Regulatory T-cell (Treg) and.
European Respiratory Journal 08/08/2019 07:29
Rationale. Patients with fibrotic interstitial lung disease (ILD) frequently develop resting or exertional hypoxaemia. There is heterogeneity in clinical practice and a paucity of evidence guiding supplemental oxygen use in this patient population. The objectives of this study were to build international expert-based consensus on the indications and goals of supplemental oxygen from the perspective of healthcare providers, and identify potential barriers to its access. Methods. Semistructured interviews and a comprehensive literature search informed items for the Delphi survey, with items not meeting consensus included in round 2. Round 3 contained survey questions regarding regional funding coverage for oxygen therapy. A priori definitions o.
European Respiratory Journal 08/08/2019 07:29
We read the recent article published in the European Respiratory Journal by Boehm et al. [1] with great interest: their study is the first to explore global chronic obstructive pulmonary disease (COPD) awareness using Google searches. Currently, with the development of the internet and search engines, Google Trends has emerged as a robust tool to investigate the interest of the general population in medical conditions [2–4]. In the study by Boehm et al. [1], it was found that the awareness of COPD in the real world is rising, while it is highly under-represented in the public interest compared with other common conditions. In addition, public interest in seeking COPD information through Google searches presented a seasonal pattern, with pea.
European Respiratory Journal 08/08/2019 07:29
Introduction. Delirium ranks among the most common complications after cardiac surgery. Although various risk factors have been identified, the association between sleep disordered breathing (SDB) and delirium has barely been examined so far. Here, our objectives were to determine the incidence of post-operative delirium and to identify the risk factors for delirium in patients with and without SDB. Methods. This subanalysis of the ongoing prospective observational study CONSIDER-AF ( identifier NCT02877745) examined risk factors for delirium in 141 patients undergoing cardiac surgery. The presence and type of SDB were assessed with a portable SDB monitor the night before surgery. Delirium was prospectively assessed with the validated Confusi.
European Respiratory Journal 08/08/2019 07:29
The National Lung Screening Trial (NLST) demonstrated that low-dose computed tomography (LDCT) screening reduced lung cancer mortality by 20% [1]. Lung cancer screening was subsequently recommended by the US Preventive Services Taskforce (USPSTF) for patients at high risk of lung cancer [2], but European nations have awaited the results of the Dutch–Belgian NELSON trial [3] before committing to national programmes. The initial findings from NELSON, presented recently at the World Conference on Lung Cancer [4], appear to confirm the reduction in lung cancer mortality, and will increase the impetus for implementation in Europe. A European position statement on lung cancer screening identified specific actions required prior to systematic LDCT.
European Respiratory Journal 08/07/2019 19:05
Asthma is a heterogeneous condition characterised by chronic inflammation and airway remodelling. T2-mediated airway inflammation, characterised by IL4, IL5 and IL13, has been the recent focus of pharmacotherapy, with a host of targeted biologic agents now available to clinicians [1]. The anti-IL5R agent, benralizumab, causes depletion of eosinophils and basophils via antibody dependent cell-mediated cytotoxicity (ADCC) in blood; however, the mechanism of action in the tissue is uncertain. Benralizumab has reduced exacerbations and improved lung function in clinical trials.
European Respiratory Journal 08/07/2019 19:05
Background. Emerging evidence suggests that air pollution may contribute to childhood asthma development. We estimated the burden of incident childhood asthma that may be attributable to outdoor NO 2 , PM 2.5 and black carbon (BC) in Europe. Methods. We combined country-level childhood incidence rates and pooled exposure-response functions with children's (1–14 years) counts, and exposure estimates at 1 540 386 1 km x 1 km cells, across 18 European countries and 63 442 419 children. Annual average pollutant concentrations were obtained from a validated and harmonised European land-use regression (LUR) model. We investigated two exposure reduction scenarios. For the first, we used recommended annual World Health Organization (WHO) air quality
European Respiratory Journal 08/07/2019 19:05
Purpose. This Phase 2 study was designed to assess the efficacy, safety and tolerability of immediate-release (IR) orally administered ralinepag, a selective, non-prostanoid prostacyclin receptor (IP) agonist with a 24-hour terminal half-life, compared to placebo in adult patients with symptomatic pulmonary arterial hypertension (PAH). Methods. Sixty-one PAH patients who were receiving standard of care, including mono or dual PAH -targeted background therapy were randomised 2:1 to ralinepag (n=40) or placebo (n=21).

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